Search results for: poor outcome of delayed breast cancer treatment

Authors: Mantas Sakalas, Paulius Sakalas

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This paper presents an analysis and design of a ultrawideband 1.8GHz to 43GHz Low Noise Amplifier (LNA) in 0.1 μm Galium Arsenide (GaAs) pseudomorphic High Electron Mobility Transistor (pHEMT) technology. The feedback based bandwidth extension techniques is analyzed and based on the outcome, a two stage LNA is designed. The impedance fine tuning is implemented by using Transmission Line (TL) structures. The measured performance shows a good agreement with simulation results and an outstanding wideband noise matching. The measured small signal gain was 12 dB, whereas a 3 dB gain flatness in range from 1.8 - 43 GHz was reached. The noise figure was below 4 dB almost all over the entire frequency band of 1.8GHz to 43GHz, the output power at 1 dB compression point was 6 dBm and the DC power consumption was 95 mW. To the best knowledge of the authors the designed LNA outperforms the State of the Art (SotA) reported LNA designs in terms of combined parameters of noise figure within the addressed ultra-wide 3 dB bandwidth, linearity and DC power consumption.

Keywords: feedback amplifiers, GaAs pHEMT, monolithic microwave integrated circuit, LNA, noise matching

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Authors: Andrej Golowin, Viktor Denk, Axel Riepe

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Solid fan blades and discs in aero engines are subjected to high combined low and high cycle fatigue loads especially around the contact areas between blade and disc. Therefore, special coatings (e.g. dry film lubricant) and surface treatments (e.g. shot peening or laser shock peening) are applied to increase the strength with respect to combined cyclic fatigue and fretting fatigue, but also to improve damage tolerance capability. The traditional deterministic damage tolerance assessment based on fracture mechanics analysis, which treats service damage as an initial crack, often gives overly conservative results especially in the presence of vibratory stresses. A probabilistic damage tolerance methodology using crack initiation data has been developed for fan discs exposed to relatively high vibratory stresses in cross- and tail-wind conditions at certain resonance speeds for limited time periods. This Monte-Carlo based method uses a damage databank from similar designs, measured vibration levels at typical aircraft operations and wind conditions and experimental crack initiation data derived from testing of artificially damaged specimens with representative surface treatment under combined fatigue conditions. The proposed methodology leads to a more realistic prediction of the minimum damage tolerance life for the most critical locations applicable to modern fan disc designs.

Keywords: combined fatigue, damage tolerance, engine, surface treatment

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Authors: Carlos Alves

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This research paper demonstrates how payments for environmental services (PES) can be an effective mechanism to combat food insecurity and reduce environmental degradation in developing countries. The paper begins by discussing how environmental services affect each one of the pillars of food security: availability, access, and utilization of food. However, due to numerous global environmental challenges, a new pillar of food security based on environmental sustainability is proposed and discussed. An argument is then made that PES can usefully combat food insecurity. It can provide an extra income to those who take on environmental service and help them to have a better access to food. In order to be successful in addressing food insecurity, PES schemes should target on the poor and redress issues that can prevent their effectiveness. Finally, the research presents a case study that discusses how several developing countries addressed problems and successfully developed PES programs.

Keywords: environmental sustainability, food security, nutrition, payments for environmental services

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Authors: Ahmed. S. Alasmari, M. S. Soliman, Magdy M. El-Rayes

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This study focuses on the effect of the addition of magnesium (Mg) and silver (Ag) on the mechanical properties of aluminum based alloys. The alloying elements will be added at different levels using the factorial design of experiments of 2²; the two factors are Mg and Ag at two levels of concentration. The superior mechanical properties of the produced Al-Cu-Mg-Ag alloys after aging will be resulted from a unique type of precipitation named as Ω-phase. The formed precipitate enhanced the tensile strength and thermal stability. This paper further investigated the microstructure and mechanical properties of as cast Al–Cu–Mg–Ag alloys after being complete homogenized treatment at 520 °C for 8 hours followed by isothermally age hardening process at 190 °C for different periods of time. The homogenization at 520 °C for 8 hours was selected based on homogenization study at various temperatures and times. The alloys’ microstructures were studied by using optical microscopy (OM). In addition to that, the fracture surface investigation was performed using a scanning electronic microscope (SEM). Studying the microstructure of aged Al-Cu-Mg-Ag alloys reveal that the grains are equiaxed with an average grain size of about 50 µm. A detailed fractography study for fractured surface of the aged alloys exhibited a mixed fracture whereby the random fracture suggested crack propagation along the grain boundaries while the dimples indicated that the fracture was ductile. The present result has shown that alloy 5 has the highest hardness values and the best mechanical behaviors.

Keywords: precipitation hardening, aluminum alloys, aging, design of experiments, analysis of variance, heat treatments

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Authors: Somayeh Sharifi

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The purpose of this study is to investigate the effects of collaborative reflection and class observation on improving the quality of teacher training courses and the students reading comprehension skills. 13 inexperienced English teachers teaching elementary courses that were at the same level of proficiency were chosen. Thirteen participants were allocated in two groups, with 7 teachers in the experimental group and the other 6 teachers in the control group. Since two groups were not selected randomly, this study is a form of quasi-experimental research. In addition to a 3-day teacher training course for both groups, teachers in experimental group recorded and observed 20 sessions of their own classes and 30 sessions of experienced teachers’ class and participated in 12 meetings -3 month once a week- in which teachers shared any event that they found interesting during observations and their own teaching and compare it with strategies that they learned in teacher training courses. In contrast, the control group did not engage in any process of observation and collaboration. In order to test students' performance in English before and after the treatment, a Key English Test (KET) was employed to check students' reading skill. The result of the test shows that there is not a significant difference in mean of scores in KET pretest in and, since they are close to each other. However by considering mean and median of posttest in both classes we perceive that although both control and experimental group students' proficiency in English enhanced, there was a significant difference in experimental group students' final scores before and after treatment.

Keywords: collaborative reflection, reading comprehension, teacher training courses, key English test (KET)

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Authors: Enebe Christian Chukwudi

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Water bodies around the world notably underground water, ground water, rivers, streams, and seas, face degradation of their water quality as a result of activities associated with coal utilization including coal mining, coal processing, coal burning, waste storage and thermal pollution from coal plants which tend to contaminate these water bodies. This contamination results from heavy metals, presence of sulphate and iron, dissolved solids, mercury and other toxins contained in coal ash, sludge, and coal waste. These wastes sometimes find their way to sources of urban water supply and contaminate them. A major problem encountered in the supply of potable water to Enugu municipality is the contamination of Ajali River, the source of water supply to Enugu municipal by coal waste. Hydro geochemical analysis of Ajali water samples indicate high sulphate and iron content, high total dissolved solids(TDS), low pH (acidity values) and significant hardness in addition to presence of heavy metals, mercury, and other toxins. This is indicative of the following remedial measures: I. Proper disposal of mine wastes at designated disposal sites that are suitably prepared. II. Proper water treatment and III. Reduction of coal related contaminants taking advantage of clean coal technology.

Keywords: effects, coal, utilization, water quality, sources, waste, contamination, treatment

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Authors: Rahil Malekipoor, Zora Singh, Alan Payne

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Ethylene management during storage life of organically grown apples is a challenging issue due to limited available options. The objective of this investigation was to examine the effects of lemon and cinnamon oils fumigation on storage life, the incidence of superficial scald and quality of Granny Smith apple which were kept in cold storage with and without ozone. The fruit was fumigated with 3µl L⁻¹ lemon or cinnamon oil for 24 h and untreated fruit was kept as a control. Following the treatments, the fruit was stored at (0.5 to -1°C) with and without ozone for 100 and 150 days. After each storage period, ethylene production and respiration rate, superficial scald and various fruit quality parameters were estimated. Lemon oil fumigated fruit showed significantly reduced the mean climacteric peak ethylene production rate in both 100 and 150 days stored fruit. Mean climacteric peak ethylene production rate was significantly reduced in the apples which were kept in an ozonated as compared to cold stored without ozone for 100 days only. The climacteric ethylene peak was delayed only in 100 days cold stored fruit with ozone (8.78 d) as compared to without ozone (3.89 d). Firmness was significantly higher in the fruit fumigated with lemon or cinnamon oil compared to control for both storage time. The fruit stored for 150 days in cold storage without ozone exhibited higher mean firmness than those stored in ozonated. Lemon or cinnamon oil fumigation significantly reduced superficial scald in both cold stored fruit with or without ozone. Levels of total phenols were significantly higher in cinnamon oil treated fruit and stored for 100 days as compared to all other treatments. In 150 days stored fruit fumigated with lemon oil showed the significantly higher level of total phenols compared to cinnamon oil fumigation and control. The fruit fumigated with lemon oil or cinnamon oil following 150 days cold storage resulted in significantly higher levels of ascorbic acid and antioxidant capacity as compared to the control fruit. In conclusion, lemon oil fumigation was more effective in suppressing ethylene production in 100-150 days cold stored fruit than cinnamon oil. Whilst, fumigation of both lemon or cinnamon oil were effective in reducing superficial scald and maintaining quality in 100-150 days cold stored fruit.

Keywords: apple, cold storage, organic oil, ozone

Procedia PDF Downloads 142

Authors: Balamurugan Baladhandapani, Ganesh Renganathan, V. R. Sanal Kumar

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In this paper a comprehensive review on various factory layouts has been carried out for designing a lucrative process layout for medium scale industries. Industry data base reveals that the end product rejection rate is on the order of 10% amounting large profit loss. In order to avoid these rejection rates and to increase the quality product production an intermediate non-destructive testing facility (INDTF) has been recommended for increasing the overall profit. We observed through detailed case studies that while introducing INDTF to medium scale industries the expensive production process can be avoided to the defective products well before its final shape. Additionally, the defective products identified during the intermediate stage can be effectively utilized for other applications or recycling; thereby the overall wastage of the raw materials can be reduced and profit can be increased. We concluded that the prudent design of a factory layout through critical path method facilitating with INDTF will warrant profitable outcome.

Keywords: intermediate non-destructive testing, medium scale industries, process layout design

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Authors: Emma Dwi Ariyani, Dini Hadiani

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This article reports the descriptive analysis of self-compassion in polytechnic students. It has been long believed that self-compassion can improve students’ motivation in completing their studies. This research was conducted with the aim to see the degree of self-compassion in polytechnic students in Indonesia by using Neff's Self-Compassion Scale (short form) measurement tool consisting of 12 items. The research method used was descriptive study with survey technique on 255 students. The results showed that 78% of students had low self-compassion and 22% had high self-compassion. This revealed that polytechnic students still criticize themselves harshly, make a poor judgment and bad self-appraisal, and they also cannot accept their imperfection and consider it as a self-judgment. The students also tend to think that they are the only ones that experience failure and suffering. This can lead to a sense of isolation (self-isolation). Furthermore, the students are often too concerned with aspects that are not liked both in themselves and in life (over-identification). Improving the students’ level of self-compassion can be done by building an educational climate that not only criticizes the students but provides feedback as well. This should focus on the students’ real behavior rather than the students’ general character.

Keywords: descriptive study, polytechnic students, Indonesia, self-compassion

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Authors: Simon Ibor Akpama

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The study investigated the extent to which innovative teaching-learning techniques can influence and attenuate learning difficulties among adult learners participating in different literacy education programmes in Calabar Metropolis, Cross River State, Nigeria. A quasi-experimental design was adopted to collect data from a sample size of 150 participants of the programme. The sample was drawn using the simple random sampling method. As an experimental study, the 150 participants were divided into two equal groups –the first was the experimental group while the second was the control. A pre-test was administered to the two groups which were later exposed to a post-test after treatment. Two instruments were used for data collection. The first was the guide for the Literacy Learning Difficulties Inventory (LLDI). Three hypotheses were postulated and tested as .05 level of significance using Analysis of Covariance (ANOVA) test statistics. Results of the analysis firstly showed that the two groups (treatment and control) did not differ in the pre-test regarding their literacy learning difficulties. Secondly, the result showed that for each hypothesis, innovative teaching-learning techniques significantly influenced adult learners’ (participants) literacy learning difficulties. Based on these findings, the study recommends the use of innovative teaching-learning techniques in adult literacy education centres to mitigate the learning difficulties of adult learners in literacy education programmes in Calabar Metropolis.

Keywords: teaching, learning, techniques, innovative, difficulties, programme

Procedia PDF Downloads 119

Authors: Abdallah Bouguettoucha, Derradji Chebli, Tariq Yahyaoui, Hichem Attout

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The effect of acid -basic treatment of lingocellulosic material (forest wastes wild carob) on Ethyl violet adsorption was investigated. It was found that surface chemistry plays an important role in Ethyl violet (EV) adsorption. HCl treatment produces more active acidic surface groups such as carboxylic and lactone, resulting in an increase in the adsorption of EV dye. The adsorption efficiency was higher for treated of lingocellulosic material with HCl than for treated with KOH. Maximum biosorption capacity was 170 and 130 mg/g, for treated of lingocellulosic material with HCl than for treated with KOH at pH 6 respectively. It was also found that the time to reach equilibrium takes less than 25 min for both treated materials. The adsorption of basic dye (i.e., ethyl violet or basic violet 4) was carried out by varying some process parameters, such as initial concentration, pH and temperature. The adsorption process can be well described by means of a pseudo-second-order reaction model showing that boundary layer resistance was not the rate-limiting step, as confirmed by intraparticle diffusion since the linear plot of Qt versus t^0.5 did not pass through the origin. In addition, experimental data were accurately expressed by the Sips equation if compared with the Langmuir and Freundlich isotherms. The values of ΔG° and ΔH° confirmed that the adsorption of EV on acid-basic treated forest wast wild carob was spontaneous and endothermic in nature. The positive values of ΔS° suggested an irregular increase of the randomness at the treated lingocellulosic material -solution interface during the adsorption process.

Keywords: adsorption, isotherm models, thermodynamic parameters, wild carob

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Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Background & Objectives: Audio-visual aids and computer-assisted language instruction (CALI) effects are strong in teaching language components (sound system, grammatical structures and vocabulary) to students of special needs. To explore the effects of the audio-visual aids and CALI in teaching sound system to this class of students by speech language therapists (SLTs), an experiment has been undertaken to evaluate their performance during their study of the sound system course. Methods: Forty students (males and females) of special needs at al-Malādh school for teaching students of special needs in Dhamar (Yemen) range between 8 and 18 years old underwent this experimental study while they were studying language sound system course. Pre-and-posttests have been administered at the begging and end of the semester. Students' treatment was compared to a similar group (control group) of the same number under the same environment. Whereas the first group was taught using audio-visual aids and CALI, the second was not. Students' performances were linguistically and statistically evaluated. Results & conclusions: Compared with the control group, the treatment group showed significantly higher scores in the posttest (72.32% vs. 31%). Compared with females, males scored higher marks (1421 vs. 1472). Thus, we should take the audio-visual aids and CALI into consideration in teaching sound system to students of special needs.

Keywords: language components, sound system, audio-visual aids, CALI, students, special needs, SLTs

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Authors: Andrea Szabó Nagy, János Szabó, Zsófia Csanádi, József Erdős

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The main objective of this study was to assess the seasonal variation of atmospheric polycyclic aromatic hydrocarbon (PAH) concentrations associated with PM10 in an urban site of Győr, Hungary. A total of 112 PM10 aerosol samples were collected in the years of 2012 and 2013 and analyzed for PAHs by gas chromatography method. The total PAH concentrations (sum of the concentrations of 19 individual PAH compounds) ranged from 0.19 to 70.16 ng/m3 with the mean value of 12.29 ng/m3. Higher concentrations of both total PAHs and benzo[a]pyrene (BaP) were detected in samples collected in the heating seasons. Using BaP-equivalent potency index on the carcinogenic PAH concentration data, the local population appears to be exposed to significantly higher cancer risk in the heating seasons. However, the comparison of the BaP and total PAH concentrations observed for Győr with other cities it was found that the PAH levels in Győr generally corresponded to the EU average.

Keywords: air quality, benzo[a]pyrene, PAHs, polycyclic aromatic hydrocarbons

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Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

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Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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Authors: Sumayah Mohammed Asiri A., Aviva Levina B., Elizabeth New C., Peter Lay D.

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Pt compounds have been among the most successful anticancer drugs in the last 40 years, but the development of resistance to them is an increasing problem. Cellular homeostasis of an essential metal, Cu, is known to be involved in Pt resistance, but mechanisms of this process are poorly understood. We used a novel ratiometric Cu(I)-sensitive fluorescent probeInCCu1 dye to detect Cu(I) in the mitochondria. Total Cu and labile Cu pool measured using AAS and InCCu1 dye in A2780 cells and their corresponding resistant cells A2780-cis.R cells treated with Cu and cisplatin. The main difference between both cell lines in the presence and absence of Cu(II) is that resistant cells have lower total Cu content but higher labile Cu levels than cisplatin-sensitive cells. This means that resistant cells can metabolize and export excess Cu more efficiently. Furthermore, InCCu1 has emerged not only as an indicator of labile cellular Cu levels in the mitochondria but as a potentially versatile multi-organelle probe.

Keywords: AAS and ICPMS, A2780 and its resistant cells, ratiometric fluorescent sensors, inCCu1, and total and labile Cu

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Authors: Panprapa Yongtrakul, Punyaphat Sirithanabadeekul, Pakjira Siriphan

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Background: The thread lift technique has become popular because it is less invasive, requires a shorter operation, less downtime, and results in fewer postoperative complications. The advantage of the technique is that the thread can be inserted under the skin without the need for long incisions. Currently, there are a lot of thread lift techniques with respect to the specific types of thread used on specific areas, such as the mid-face, lower face, or neck area. Objective: To review the thread lift technique for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. Materials and Methods: A literature review technique was conducted by searching PubMed and MEDLINE, then compiled and summarized. Result: We have divided our protocols into two sections: Protocols for short suture, and protocols for long suture techniques. We also created 3D pictures for each technique to enhance understanding and application in a clinical setting. Conclusion: There are advantages and disadvantages to short suture and long suture techniques. The best outcome for each patient depends on appropriate patient selection and determining the most suitable technique for the defect and area of patient concern.

Keywords: thread lift, thread lift method, thread lift technique, thread lift procedure, threading

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Authors: M. Shadmand

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The curing process of insulation system for electrical machines plays a determinative role for its durability and reliability. Polar structure of insulating resin molecules and used filler of insulation system can be taken as an occasion to leverage it to enhance overall characteristics of insulation system, mechanically and electrically. The curing process regime for insulating system plays an important role for its mechanical and electrical characteristics by arranging the polymerization of chain structure for resin. In this research, the effect of electrical field application on in-curing insulating system for Global Vacuum Pressurized Impregnation (GVPI) system for traction motor was considered by performing the dissipation factor, polarization and de-polarization current (PDC) and voltage endurance (aging) measurements on sample test objects. Outcome results depicted obvious improvement in mechanical strength of the insulation system as well as higher electrical characteristics with routing and long-time (aging) electrical tests. Coming together, polarization of insulation system during curing process would enhance the machine life time. 

Keywords: insulation system, GVPI, PDC, aging

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Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

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The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

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This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

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Authors: Ortega Ivan, De La Plaza Edurne

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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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Authors: Azeez Ayodele Ayodele

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This paper investigated the problem of picture books design and the quality of the pictures in picture books. The research surveyed nursery and primary schools in four major cities in southwest of Nigeria. The instruments including the descriptive survey questionnaire and a structured interview were developed, validated and administered for collection of relevant data. Descriptive statistics was used in analyzing the data. The result of the study revealed that there were poor quality of pictures in picture books and this is due to scarcity of trained graphic designers who understand systems approach to picture books design and production. There is thus a need for more qualified graphic designers, given in-service professional training as well as a refresher course as criteria for upgrading by the stakeholders.

Keywords: pictures, picture books, pre-primary schools, trained graphic designers

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Authors: Hakima Althalb

Abstract:

Petroleum contamination of sandy soils is a severe environmental problem in Libya, but relatively little work has been carried out to optimize the bioremediation of such heavily contaminated soil, particularly at a pilot scale. The purpose of this research was to determine the potential for the microbial-based bioremediation of hydrocarbon-contaminated soil obtained from an oil refinery in Libya and to assess the potential of both ozonation and phytoremediation (both applied after initial bioremediation) to reduce residual hydrocarbon levels. Plots containing 500 kg soil (triplicates) (contaminated soil diluted with clean soil 50% volume) were set up, (designated as Land Treatment Units; LTUs) containing five different nutrient levels and mixtures (Urea + NPK (nitrogen; phosphor; potassium) mixtures) to obtain C:N:P ratios 100:10:1, and monitored for 90 days. Hydrocarbon levels, microbial numbers, and toxicity (EC50 using luminescent microbial based tests) were assessed. Hydrocarbon levels in non-diluted and diluted soil ranged from 20 733-22 366 mg/kg and from 16 000-17 000 mg/kg respectively. Although all the land treatment units revealed a significant hydrocarbon reduction over time, the highest reduction in hydrocarbon levels obtained was around 60%. For example, 63% hydrocarbon removal was observed using a mixture of urea and NPK with a C:N:P ratio of 100:10:1). Soil toxicity (as assessed using luminescence based toxicity assays) reduced in line with the reduction in total petroleum hydrocarbons observed. However, as relatively high residual TPH (total petroleum hydrocarbon) levels (ranging from 6033-14166mg/kg) were still present after initial bioremediation two ‘post-treatments’ (phytoremediation and ozonation) were attempted to remove residual hydrocarbons remaining. Five locally grown (agriculturally important) plant species were tested. The germination of all plants examined was strongly inhibited (80-100%) and seedlings failed to grow well in the contaminated soil, indicating that the previously bioremediated soils were still toxic to the plants. Subsequent ozonation followed by another bioremediation of soil was more successful than phytoremediation. But even the most promising successful treatment in this study (ozonation for 6 hours at 25ppm followed by bioremediation) still only removed approximately 31% of the residual hydrocarbons. Overall, this work showed that the bioremediation of such highly contaminated soils is difficult and that a combination of treatments would be required to achieve successful remediation. Even after initial dilution and bioremediation the soils remained toxic to plant growth and were therefore not suitable for phytoremediation.

Keywords: bioremediation, petroleum hydrocarbons, ozone, phytoremediation

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Authors: Alireza Abbassi Monjezi, Mohammad Hasan Shaheed

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Flood, caused by excessive rainfall, monsoon, cyclone and tsunami is a common disaster in many countries of the world especially sea connected low-lying countries. A stand-alone self-powered water filtration module for decontamination of floodwater has been designed and modeled. A combination forward osmosis – low pressure reverse osmosis (FO-LPRO) system powered by solar photovoltaic-thermal (PVT) energy is investigated which could overcome the main barriers to water supply for remote areas and ensure off-grid filtration. The proposed system is designed to be small scale and portable to provide on-site potable water to communities that are no longer themselves mobile nor can be reached quickly by the aid agencies. FO is an osmotically driven process that uses osmotic pressure gradients to drive water across a controlled pore membrane from a feed solution (low osmotic pressure) to a draw solution (high osmotic pressure). This drops the demand for high hydraulic pressures and therefore the energy demand. There is also a tendency for lower fouling, easier fouling layer removal and higher water recovery. In addition, the efficiency of the PVT unit will be maximized through freshwater cooling which is integrated into the system. A filtration module with the capacity of 5 m3/day is modeled to treat floodwater and provide drinking water. The module can be used as a tool for disaster relief, particularly in the aftermath of flood and tsunami events.

Keywords: flood resilience, membrane desalination, portable water treatment, solar energy

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Authors: Eldah Ephraim Buba, Amina Bata Zoaka, Aishatu Ibrahim

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This study appraised maintenance practices in selected tourist attractions in Bauchi state, Nigeria. Four tourist attractions were used for the research. Checklists were used to assess operations and repairs maintenance practices in the different attractions. The study carried out personal assessment thrice in six months without prior knowledge of the staff in charge for operational maintenance. Records of repairs maintenance from the attractions maintenance unit for a period of ten years were assessed using the checklists. The findings of the study show that operations maintenance was not adequately carried out in the four tourists attractions. Repairs maintenance was carried out in Yankari game reserve and safari, but repairs maintenance was poor in the other three attractions. The study therefore, recommends that adequate maintenance should be practiced in tourist attractions to expand the lifespan of the facilities and also encourage tourist patronage.

Keywords: appraisal, maintenance, practices, tourist attraction

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Authors: Sanjeev Gupta, Ankit Prabhakar, K. Rajkumar Singh

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Sunni Dam Hydroelectric Project (382 MW) is a run of river type development with an underground powerhouse, proposed to harness the hydel potential of river Satluj in Himachal Pradesh, India. The project is located in the inner lesser Himalaya between Dhauladhar Range in the south and the higher Himalaya in the north. The project comprises two large underground caverns, a Powerhouse cavern (171m long, 22.5m wide and 51.2m high) and another transformer hall cavern (175m long, 18.7m wide and 27m high) and the rock pillar between the two caverns is 50m. The highly jointed, fractured, anisotropic rock mass is a key challenge in Himalayan geology for an underground structure. The concern for the stability of rock mass increases when weak/shear zones are encountered in the underground structure. In the Sunni Dam project, 1.7m to 2m thick weak/shear zone comprising of deformed, weak material with gauge has been encountered in powerhouse cavern at 70m having dip direction 325 degree and dip amount 38 degree which also intersects transformer hall at initial reach. The rock encountered in the powerhouse area is moderate to highly jointed, pink quartz arenite belonging to the Khaira Formation, a transition zone comprising of alternate grey, pink & white quartz arenite and shale sequence and dolomite at higher reaches. The rock mass is intersected by mainly 3 joint sets excluding bedding joints and a few random joints. The rock class in powerhouse mainly varies from poor class (class IV) to lower order fair class (class III) and in some reaches, very poor rock mass has also been encountered. To study the stability of the underground structure in weak/shear rock mass, a 3D numerical model analysis has been carried out using RS3 software. Field studies have been interpreted and analysed to derive Bieniawski’s RMR, Barton’s “Q” class and Geological Strength Index (GSI). The various material parameters, in-situ characteristics have been determined based on tests conducted by Central Soil and Materials Research Station, New Delhi. The behaviour of the cavern has been studied by assessing the displacement contours, major and minor principal stresses and plastic zones for different stage excavation sequences. For optimisation of the support system, the stability of the powerhouse cavern with different powerhouse orientations has also been studied. The numerical modeling results indicate that cavern will not likely face stress governed by structural instability with the support system to be applied to the crown and side walls.

Keywords: 3D analysis, Himalayan geology, shear zone, underground power house

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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Authors: N. Musayeva, N. Rustamova, N. Bagirov, S. Ibadov

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Purpose: to analyze the long-term results of external dacryocystorhinostomy (DCR), which remains the preferred primary procedure in the surgical treatment of lacrimal duct obstruction in chronic dacryocystitis. Methodology: long-term results of external DCR (after 3 years) performed on 90 patients (90 eyes) with chronic dacryocystitis from 2018 to 2020 were evaluated. The Azerbaijan National Center of Ophthalmology, named after acad. Zarifa Aliyeva. 15 of the patients were men, 75 – women. The average age was 45±3.2 years. Surgical operations were performed under local anesthesia. All patients suffered from diabetes mellitus for more than 3 years. All patients underwent external DCR and silicone drainage (tube) was implanted. In the postoperative period (after 3 years), lacrimation, purulent discharge, and the condition of the scar at the operation site were assessed. Results: All patients were under observation for more than 18 months. In general, the effectiveness of the surgical operation was 93.34%. Recurrence of disease was observed in 6 patients and in 3 patients (3.33%), the scar at the site of the operation was rough (non-cosmetic). In 3 patients (3.33%) – the surgically formed anastomosis between the lacrimal sac and the nasal bone was obstructed by scar tissue. These patients were reoperated by trans canalicular laser DCR. Conclusion: Despite the long-term (more than a hundred years) use of external DCR, it remains one of the primary techniques in the surgery of chronic dacryocystitis. Due to the high success rate and good long-term results of DCR in the treatment of chronic dacryocystitis in patients suffering from diabetes mellitus, we recommend external DCR for this group of patients.

Keywords: chronic dacryocystitis, diabetes mellitus, external dacryocystorhinostomy, long-term results

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: Saima Akbar

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The global financial crisis severely and adversely impacted the Pakistanis’ financial setups with far-reaching consequences for its victims. This study aimed to analyze the various determinants of the banks’ financial performance in Pakistan. The stepwise multiple regression analysis and pre-post analysis were carried out in this regard by using SPSS ver 22. The study found that the assets quality is the most influential determinant of return over assets followed by bank size and solvency. Advances, liquidity, investments, and size have positive while poor assets quality and deposits have a negative impact on the return over assets. The comparison of the pre-crisis and post-crisis coefficient values of the independent variables revealed that the global financial crisis had exerted a significant impact on the relative ability of the financial performance determinants to explain variations in return over assets.

Keywords: pre-crisis, post-crisis, coefficient values, determinants

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